Individual provider Active NPI

Susan Carrie Gutwillig, LMHC

  • Mental Health Counselor
  • Webster, MA
National Provider Identifier
1386268647
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LMHC10002860 Issued in MA
Practice address
340 Thompson Rd
Webster, MA 01570-1509
Phone
(508) 949-8905
Fax
(508) 943-2604
NPI assigned
Jun 2, 2020
Last updated
Oct 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LMHC10002860 MA Primary

Addresses

Primary practice location

340 Thompson Rd
Webster, MA 01570-1509

Mailing address

PO Box 415348
Boston, MA 02241-5348

Other practice location 1

10 Asylum St
Milford, MA 01757-2203
Phone (508) 478-6888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241113001183 MA Practitioner - Mental Health Counselor 7012441058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

340 Thompson Rd
Webster, MA 01570-1509
Phone (508) 943-5132

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMHC10002860MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc CurrentSince Oct 4, 2024 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Oct 4, 2024 Accepting new patients
Wayside Youth and Family Support Network Mental Health PastSince Jun 1, 2020 Accepting new patients

Locations

340 Thompson Rd
Webster, MA 01570
Phone (508) 943-2600

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1386268647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 THOMPSON RD",
            "city": "WEBSTER",
            "state": "MA",
            "postal_code": "015701509",
            "telephone_number": "508-949-8905",
            "fax_number": "508-943-2604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Asylum St",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "MA",
            "postal_code": "017572203",
            "country_code": "US",
            "telephone_number": "508-478-6888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUTWILLIG",
        "first_name": "SUSAN",
        "middle_name": "CARRIE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "LMHC10002860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, MA

Sources for this page

Verify at the official NPI Registry.